View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0354	ICR Reference No: 199305-0938-002
Status: Historical Active	Previous ICR Reference No: 199004-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: EARLY AND PERIODIC SCREENING DIAGNOSTIC AND TREATMENT (EPSDT) REPORT
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/04/1993
	Date Received in OIRA: 05/13/1993
Terms of Clearance: This information collection is approved through 7-95 under the following condition: HCFA will add a burden estimate statement to the instructions accompanying the 416. Upon the next submission, HCFA will also provide information on the success of the States in collecting screening information on children in managed or continuing care.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/1995	09/30/1995	06/30/1993
Responses	56	0	56
Time Burden (Hours)	1,568	0	1,176
Cost Burden (Dollars)	0	0	0

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